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Association of Inflammatory Bowel Disease and Acute Anterior Uveitis, but Not Psoriasis, With Disease Duration in Patients With Axial Spondyloarthritis
Author(s) -
Varkas Gaëlle,
Vastesaeger Nathan,
Cypers Heleen,
Colman Roos,
Renson Thomas,
Praet Liesbet Van,
Carron Philippe,
Raeman Frank,
Devinck Mieke,
Gyselbrecht Lieve,
Corluy Luc,
Piette Yves,
Lenaerts Jan,
Thevissen Kristof,
Vanneuville Benedicte,
Bosch Filip Van den,
Elewaut Dirk
Publication year - 2018
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.40551
Subject(s) - medicine , ankylosing spondylitis , psoriasis , inflammatory bowel disease , spondylitis , psoriatic arthritis , cohort , uveitis , prospective cohort study , epidemiology , disease , cohort study , reactive arthritis , relative risk , surgery , gastroenterology , dermatology , confidence interval , immunology
Objective To determine the link between extraarticular manifestations ( EAM s) and baseline characteristics in patients with axial spondyloarthritis (SpA), and to define their potentially differential prognostic value in 2 large, independent Belgian axial SpA cohorts with distinct recruitment periods. Methods Information on demographic and clinical characteristics and extraarticular manifestations ( EAM s) was obtained from patients with axial SpA originating from the (Be)Giant (Belgian Inflammatory Arthritis and Spondylitis) cohort, which includes consecutive axial SpA patients whose data have been collected since 2010, and from the ASPECT (Ankylosing Spondylitis Patients Epidemiological Cross‐sectional Trial) cohort, a Belgian registry of cross‐sectional data collected between February 2004 and February 2005 from consecutive patients with ankylosing spondylitis ( AS ) or probable AS . Results Among the 1,250 Belgian patients studied, disease duration was associated with risk of developing inflammatory bowel disease ( IBD ), with an increase in risk by 20% per 10 years of disease duration (relative risk [ RR ] 1.2, P = 0.026), and associated with risk of developing acute anterior uveitis, with an increase in risk by 30% per 10 years of disease duration ( RR 1.3, P < 0.001). In the subgroup of 171 newly diagnosed patients with prospective follow‐up data, higher mean C‐reactive protein levels over time were demonstrated in those with acute anterior uveitis or IBD compared to those without EAM s or those with psoriasis alone (each P = 0.01). Conclusion The risk of developing acute anterior uveitis or IBD , but not psoriasis, in patients with axial SpA seems to increase with disease duration and appears to be linked to a higher cumulative exposure to inflammation, thus providing a possible explanation for the differential structural progression observed in those with axial SpA.